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picture1_Excel Sheet Download 6408 | Appendix3 - Standar Format


 188x       Filetype XLS       File size 0.09 MB       Source: etfonline.wi.gov


File: Excel Sheet Download 6408 | Appendix3 - Standar Format
sheet 1 claims standard claims extract format pharmacy field name cost sensitive field format field length description rxclaimnbr n n 150 15 rxclaim number the unique identifier for claim clmseqnbr ...

icon picture XLS Filetype Excel XLS | Posted on 23 Jun 2022 | 4 years ago
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...Sheet claims standard extract format pharmacy field name cost sensitive length description rxclaimnbr n rxclaim number the unique identifier for claim clmseqnbr sequence identifies specific transaction submitted as part of a ie reject paid reversal etc claimsts status p x r accountid account id groupid group memberid member mbrsex sex mbrbirth ccyymmdd date birth durkey custom reporting mbrprodcde mbrridercd carequalid care qualifier this is populated with county code mbraltinfl alternate insurance flag navitus internal mbrmedtype medicare coverage type mbrhiccde health hic datesbm clmcounter counter counts each any and dtefilled filled prodtypecde product an ncpdp allowed values are follows blank not specified universal upc related item hri national drug ndc department defense durpps cpt hcpcs ppac nappi ean din medispan gpi first databank gcn medical economics gpo ddid smart key gm icd idc diagnosis ncci snomed cdt dsm iv other productid commonly decimalqty quantity dispensed dayssup...

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